Hemophilia is the most common inherited bleeding disorder. It involves a deficiency of one of two blood-clotting substances, known as factor VIII and factor IX, and leads to the inability of the blood to clot. There are two types of hemophiliac—type A and type B—but the symptoms are the same in both types. There are about 20,000 people in the United States who have hemophilia.

Signs and Symptoms

Hemophilia may be accompanied by the following signs and symptoms:

What Causes It?

Hemophilia is an inherited disorder that almost exclusively affects men. Women are rarely affected but are the carriers who can pass the condition to their male children.

Who's Most At Risk?

Hemophilia affects people from all ethnic groups. The daughters of men with hemophilia are carriers. However, even if hemophilia runs in the family, only about half the sons of carriers will have hemophilia.

What to Expect at Your Provider's Office

Your healthcare provider will take a family history and do a physical examination, checking for deep bleeding, muscle spasms, limited joint motion, joints that are warm and enlarged, and bruises. Blood tests including tests of the blood's clotting abilities, computed tomography (CT) scans, and magnetic resonance imaging (MRI) for bleeding in the joints may be used.

Treatment Options


Hemophilia cannot be prevented, but it is possible to test to determine whether an unborn baby will have the disorder. If a person has hemophilia, the following cautionary measures should be taken:

Treatment Plan

The primary treatment for hemophilia is factor replacement therapy, which involves replacing the blood's deficient clotting factor. This factor is produced from normal human or animal blood products or is genetically engineered. A healthcare provider may also prescribe pain relievers. Physical therapy may improve joint healing and function. Surgery may be performed for complications arising from hemophilia.

Drug Therapies

A healthcare provider may prescribe the following medications:

Surgical and Other Procedures

Certain types of surgery may become necessary, including the following:

Complementary and Alternative Therapies

Conventional exams, tests, treatment, and follow-up for hemophilia are very important. Never delay conventional care when you have bleeding or have joint pain or swelling. However, there are a few CAM therapies that may be helpful in conjunction with conventional care for certain symptoms and after effects of hemophilia. The degree of spontaneous bleeding has been linked to emotional and psychological stress. Some mind/body therapies may help relieve stress and anxiety. Studies even suggest that hypnosis may reduce the need for blood transfusions.

No studies have examined the link between nutrition and hemophilia. However, it would be wise to avoid vitamin E and fish oil if you have hemophilia, as they seem to increase bleeding time by keeping platelets from clumping. Vitamin K plays a role in normal clotting and may be useful either from dietary sources or in supplement form, but research is needed in this area.

No studies have examined the value of herbs for hemophilia specifically. However, based on their own experience, herbalists may recommend herbs that strengthen blood vessels and act as astringents (causing contraction) to make bleeding less severe, such as the following: In the case of hemophilia, however, herbal remedies should not be used without the guidance of an appropriately trained health professional. In addition, people with hemophilia should avoid ginkgo (Ginkgo biloba), as it reduces platelet clumping.

There have been few studies examining the effectiveness of specific homeopathic remedies. However, a review of several case reports found that the following remedies were helpful for individuals with hemophilia and even reduced their need for blood-clotting substances like factor VIII. Before prescribing a remedy, homeopaths take into account a person's constitutional type. In homeopathic terms, a person's constitution is his or her physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors as well as any current symptoms when determining the most appropriate remedy for a particular person. Acupuncture
According to a report of two cases in Australia, acupuncture may help relieve joint problems caused by hemophilia. It may also relieve pain when other treatments have failed and may be a useful substitute for medicines that can cause bleeding.

However, guidelines and precautions should be observed in using acupuncture for hemophilia. Bleeding into certain areas of the body is a danger in acupuncture and can be fatal for someone with hemophilia; acupuncture should be used only as a last resort. If you choose to try acupuncture, work with a trained, licensed acupuncturist who has experience dealing with hemophilia.

Physical Medicine
Physical therapy may play an important role in reducing joint problems caused by repeated bleeding in those areas. The following modalities may be recommended by the physical therapist: A complete program may also include, when needed: Work with your healthcare provider to develop a program that is best for you. The routine should be used for at least 6 to 9 months to treat chronic joint inflammation and to prevent severe bleeding.

Prognosis/Possible Complications

Since 1983, improved replacement therapy techniques have reduced the risk of contracting infections such as AIDS or hepatitis from the blood supply, and this has lengthened lives. The life expectancy for people with hemophilia who do not have AIDS is 68 years. In people who do not receive factor replacement therapy, complications include the destruction of bones and joints, life-threatening cysts, bleeding in the brain, airway obstruction, gangrene, bleeding into muscles causing damage to nerves, chronic bruising, and anemia. Sudden bleeding can occur with emotional stress.

Following Up

Your healthcare provider will want to see you every 6 to 12 months. Your provider may also suggest centers where you can receive a range of treatments and learn more about how to manage your condition.


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